Hospital episode statistics (HES) is a database of details for: all hospital admissions (known as Admitted Patient Care), Accident and Emergency (A&E) attendances and outpatient appointments at NHS hospitals in England. In this bulletin only the Admitted Patient Care dataset is used to determine first presentations.
In this bulletin, an emergency presentation for cancer is defined as a first inpatient admission where the diagnostic code indicates a presentation of cancer, and where there is an emergency method of admission identified from Admitted Patient Care (HES).
A first presentation is considered an emergency if the method of admission is either:
- Emergency: via Accident and Emergency (A&E)
- Emergency: via general practitioner
- Emergency: via Bed Bureau (this is emergency occurring while an inpatient (excluding A&E) for another reason)
- Emergency: via other means including A&E department of another trust.
‘Emergency: via consultant outpatient clinic’ is not considered an emergency presentation. This is because the patient was already within a secondary care setting when referred to the inpatient appointment and therefore the patient’s entry into secondary care is unlikely to be an emergency.
First inpatient admissions for cancer
The denominator is the number of first inpatient admissions having a primary diagnostic code indicating a presentation of cancer identified from Admitted Patient Care (HES). The diagnosis codes in HES may not always include references to cancer for care that is not thought to be related to a cancer diagnosis at the time it was given. This means the metric may not include all tumours registered in the National Cancer Registration Dataset and the results presented here may differ from publicly available results such as Routes to Diagnosis. For full details of the methodology, please refer to the specifications of the Emergency Presentations metric.
The number of first inpatient admissions for cancer presenting as an emergency, divided by, the total number of first inpatient admissions for cancer, multiplied by 100.
Wilson score method is used to give 95% confidence intervals for all the proportions presented.
The likelihood ratio test and two-sided proportions Z-test were used to test whether counts or proportions, respectively, were different from each other. A p-value of 0.05 was used to determine if the test was statistically significant.
1-year rolling proportion
The 1-year rolling proportion for a stated quarter includes the previous 3 quarters’ worth of data meaning a full 12 months of data is used. The denominator is then the total number of cancer presentations for those 4 quarters and the numerator is the total emergency presentations for those 4 quarters.